<div class="box-body">
<form action="<?php echo $this->baseUrl('/index/register')?>" method="post">
	<ul>
		<li>
			<label for="fullname" class="label-text"><strong>Full Name: <span>*</span></strong></label>
			<input type="text" id="name-user" name="name-user"/>

		</li>
		<li>
			<label for="username" class="label-text"><strong>Username: <span>*</span></strong></label>
			<input type="text" id="username" name="username"/>
		</li>
		<li>
			<label for="password" class="label-text"><strong>Password: <span>*</span></strong></label>
			<input type="password" id="pass" name="pass"/>
		</li>
		<li>
			<label for="confirmpassword" class="label-text"><strong>Confirm Password:<span>*</span></strong></label>
			<input type="password" id="confirmpass" name="confirmpass"/>
		</li>
		<li>
			<label for="email" class="label-text"><strong>Email: </strong></label>
			<input type="text" id="email" name="email"/>
		</li>
		<li>
			<label for="address" class="label-text"><strong>Address: </strong></label>
			<input type="text" id="address" name="address"/>
		</li>
		<li>
			<label for="phone" class="label-text"><strong>Phone: </strong></label>
			<input type="text" id="phone" name="phone"/>
		</li>
	</ul>
	<input type="submit" value="Register"/>
	</form>
</div>